How to get health insurance after 55

Switching to or obtaining public health insurance in Germany after the age of 55 can be difficult, but it is not impossible.

The rules are strict, but there are exemptions, especially for newcomers to Germany and specific professional groups.

In this guide, we'll explain:

• Why the age of 55 is important

• Who can still get public insurance

• Your options if you're not eligible

• How costs are calculated

Let’s get going.

Why is it so hard to get health insurance after turning 55 in Germany?

In Germany, the public system generally does not allow people over 55 to switch back to statutory (public) health insurance.

It’s not all bleak, though…

Because there is no legal age limit for public health insurance itself.

If you meet the eligibility criteria, you can still join.

Even after turning 55.

The real challenge is your past insurance history.

Who can get public insurance after 55?

You can qualify for voluntary public health insurance (freiwillige gesetzliche Krankenversicherung) if one of the following applies:

• You recently had public insurance in an EU/EEA country

• You’re employed in Germany for the first time

• You were exempt from German insurance for valid reasons (e.g., living outside the EU)

• You’re a researcher or PhD student with a stipend

• You’re a spouse of a German citizen or a pensioner returning to Germany

Let’s take a closer look at these scenarios.

1. You recently had public insurance in an EU/EEA country

If you had public health insurance in an EU/EEA country for at least 12 consecutive months (or 24 months over the past 5 years), and it ended less than 3 months ago, you can join German public insurance (even if you’re over 55).

You’ll need to prove you have sufficient income to support yourself in Germany. Savings don’t count; this has to be a regular, stable income.

This path is common for remote workers and freelancers relocating to Germany later in life.

Note for retirees:

If you are already retired in another EU country and receive your pension there, you usually remain insured in that country’s health system and can access healthcare in Germany via the S1 form.

You cannot normally switch into German public insurance.

However, if your main pension comes from Germany, then you may be eligible for coverage in the German system (e.g., through public insurance for pensioners, KVdR).

2. You’re employed in Germany for the first time

If you’re starting your very first job in Germany, you can usually choose between public and private insurance regardless of age (even if your salary is above the €73,800 private threshold).

But… If you’re returning to Germany for employment and your last insurance in Germany was private, you cannot rejoin public health insurance, regardless of your age or current salary.

3. You’re already in Germany and switching employers

If you’re switching employers and your salary drops below the private threshold, you are allowed to switch to public health insurance if you can prove that you spent at least 30 months (2.5 years) of the last 5 years in public health insurance.

4. You were exempted from coverage

If you have not lived in Germany for the last 5 years or in the rest of the EU, you are eligible for public health insurance.

5. You’re a returning pensioner or the spouse of a German citizen

Two other groups often qualify for public insurance even after 55:

• Returning pensioners: If you are drawing a German pension or plan to apply for one, and had public insurance in the past, you are eligible for public health insurance for pensioners (KVdR).

• Spouses of German citizens: If your partner is publicly insured and you earn less than €485 per month (2025 threshold for dependents), you qualify for free coverage as a family member.

Who is not eligible for health insurance after 55?

You’re likely stuck with private insurance (or its alternatives) if:

• You opted out of public insurance (by choosing private health insurance) and haven’t been publicly insured since.

• You don’t meet the minimum income requirements to qualify for “voluntary coverage”

In these cases, switching to public is nearly impossible.

What to do if you’re not eligible

If switching is off the table, here are strategies for trying to make the most out of your situation:

1. Reduce your private health insurance costs

1. Negotiate your premiums: If your income has dropped, insurers may offer a lower rate tier when asked.
2. Switch to a “Basistarif”: This is a standardized, government-regulated plan with capped premiums, meant to be a close equivalent to public insurance.
3. Apply for hardship provisions (“Härtefallregelung”): Some states and insurers offer reduced premiums for individuals experiencing financial hardship.

2. Consider expat insurance

Expat insurance can serve as a short-term bridge while you determine your visa or work plans.

It has a few drawbacks, namely:

• Fewer benefits than public or traditional private insurance plans (for example, pre-existing conditions are almost always excluded).

• An age limit of 75 years for policyholders.

• Employees are not eligible for the policy.

If you’re eligible and plan to return to your home country by the age of 75 (or before), expat insurance is worth considering.

3. Plan for the long-term

It’s a common myth that private insurance premiums always rise more sharply with age than public ones.

However, recent data show that public insurance (GKV) premiums increased by 3.2%, while private (PKV) premiums rose by an average of 2.8%.

Still, planning is key.

Ask your insurer about aging reserves (Altersrückstellungen) and how they help stabilize future costs.

Before choosing a plan, consider meeting with the insurer directly: they can explain how cost-control features (like deductibles, reserve structure, and tariff options) work in your favor.

If you’re older when entering the private system, it’s smart to set aside a buffer for future increases, even if moderate.

Costs of voluntary public insurance

If you qualify for voluntary insurance, congratulations. Not everyone fits the scenarios above; you’re in luck.

In this case, your monthly contribution is income-based. Specifically:

For example, if you earn €2,000 per month, your costs will be approximately €420 per month.

Learn more: How much is health insurance in Germany?

Conclusion

Getting public health insurance in Germany after the age of 55 depends on your personal and medical history.

The system does create barriers, but there are loopholes, exemptions, and strategies you can use to find a path forward.

If you're unsure about your eligibility, we can help evaluate your situation and guide you through your options, whether that involves public, private, or transitional insurance.